| NPI | 1225658339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 013637-1) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: NY 013637-1) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NY 013637-1) | |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2020-04-18 |